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Khan bahadur Ahsanullah Memorial Lecture(Six Lecture)

Physician's Morality and Hippocratic Oath

\. National Professor(Dr) MR.KhanChairman & Director

Institute of Child Health and Shishu Shyastho Foundation Bangladesh6/2,Barobag, Mirpur-2,Dhaka-1216

1~ February 2016

Ahsanullah University of Science and Technology141-142 Love Road,Tejgaon Industrial Area,Dhaka-1208

Web:www.aust.edu

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Physician's Morality and Hippocratic Oath

Twenty first century had just started its way. My life is related with threefourth of the last century while travelling this long route of 85years.Thedestruction I felt in the personal social & national life is deterioration ofmorality. This is true not only amongst us in Bangladesh, it is a worldwidephenomenon-starting from the Iraq war to recent bombing episodes inBangladesh.

We the physicians are not exception. If we recognize part of our client'scompliant to be true, it will be a huge list and none of us can be spared. This iscertain a mistrust between the patient and Physician relationship. Theeconomic impact of this is drainage of foreign currency nearly 5000 croreTaka every year, by which can built one Jamuna Bridge each year with thisamount.

At this moment,I am recalling the Hippocratic Oath, which we all ought totake at the very beginning of our professional career. As you all knowHippocrates the father of medicine was born in the Island of Cos in Greeceabout about 2500 years back (460 B.C).At his 83 years of life(377 B.C).Hewas involved in the field of medicine. He has written many books onmedicine, the most investment amongst these was "Treatises of Epidemics"

You all know that the oath that is related with the name of Hippocrates hasbeen modifying and here we take oath on eleven issues. The world MedicalAssociation at its third General Assembly at Geneva in September 1948adapted certain code of ethics, in the form of oath to be taken by all members,at the time of entering into profession. From the position of a senior memberof this profession, I would take this opportunity to speak about a few issues ofthe code in the light of my experience.

1. "1 will be loyal to the ideals of profession of medicine and its tradition ofservice to mankind" so at the very beginning the oath speaks about theresponsibilities towards the profession and the mankind. We the

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physicians are not only a group of profession rather a very importantconstituent of the mankind as a whole.' Our respectable late NationalProfessor, Dr. Md. Ibrahim used to tell his patient "I am grateful to youthat you have' given me the opportunity to serve you. It is also thekindness of Allah, that He has also given me this chance to serve you"The empathy of this kind word towards the patients is graduallydeclining. Treatment is a holistic approach, it always should cover themental aspect of every patient by counseling or in any other means.Hence WHO as redefined health as."Health is a state of completephysical. mental, social and spiritual wellbeing, not merely the absenceof diseases(WHO,1998)" Let us show a little more respect to ourpatients, let us start it from today. You will be touched by their Loveevery day.

2. "I will follow the treatment which according to my ability and judgmentI consider best for the benefit of my patient and will abstain fromwhatever is deleterious and mischievous".

In this part of oath a physician is promising regarding his/her duties andresponsibilities towards a patient.

Here I shall share with you two of my experiences on the very beginning ofmy professional life and another at the end of my government serviceearner.

It is about 64 years back. I have completed my medical degree (MBBS)from Kolkata Medical College and I was planning to go back to my nativevillage at satkhira, from Kolkata. I then went to meet my father's friend Dr.Shib Nath Bose(Shibu Kaka) to take farewell tips and advice from him.How to start my carrier? Then he closed his eyes and looked back in hisearlier life. It was my initial period as a physician Shibu Kaka narrated ~nthis way I was taking rest in one of the rainy evening at my house inKolkata. A widow came with a humble request. Doctor, my daughter is inlabour pain and screaming, could you please come and see her? "Howmuch money do you have for me?" Thirty taka, the old widow replied. ButI felt some one was whispering in my ear. She got more money with her. If

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you press her, you can get more. I can't go less than fifty taka. The womangot this thirty taka after a lot of trouble. So I refused to go. On the nextmorning I heard the news that the patient died from obstructed labour.

After narrating this Shibu Kaka requested me with pain in his voice youplease do not do this type of negotiation with your patient. I still bear thispain and guilty feelings throughout my life, Shibu Kaka said.

The second one is at the last day of my government service in 1988 at theInstitute of post graduate Medicine and Research (IPGMR) nowBangabandhu Shekh Mujib Medical university(BSMMU) request me forsome advice. I Talked them when a sick patient comes and get cure withtreatment there is not problem. But a child comes with seriously ill and notgive them proper counseling they may think the patient died due to doctorsnegligence on the other hand if proper counseling and treatment is giveneven a second openion should be taken from another physician. Thenpatient relatives may be satisfy because as a physician can treatscientifically and with devotion and pray to Almighty for relief. I hope mydoctors and the doctor who are coming in this profession may follow myadvice.

3. The next verse of the oath is that, I will give no deadly medicine to anyone if asked, nor will I perform any abortion any operation for a criminalpurpose. The duty of a physician is to save life from birth to the lastminute of the life, not destruction.

4. "In the presence of epidemic or other danger I will not allow fear ofpersonal harm to turn me from my duty" Physician should serve allhuman suffering and calami tie's, whether it be of natural or man made.

We the physicians have been gifted by the God with his power to servehuman suffering, which he provided virtually to nor:e in the universe. Basedon this feelings an idea. I and some like minded people attempted to dosomething, built-up an organization, Shishu Sasthya Foundation" Thisorganization beside health care services in the hospital and community, alsoprovides Micro-finance among rural women, education for women and

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children, vocational training centre to child and rending health services tofive hundred thousand people for the last 18 'years. When I look back ofthese activities at a time, I feel pain and guilty that I could serve more if Ihad started it earlier in my life. This figure will be many times more bynow.

Now I humbly request all of you to start something for the peoples welfarein your own locally/Village or town), it may look small today but you know abig tree comes from a tiny seed. Please put the seed today and the people ofBangladesh is waiting for you.

5. "What ever I see or hear in the lives of men, which ought not to be spoken ornot be published that, I will keep secret" Every physician must keep thepatient's life secret, he should be a trusted friend. My fellow colleagues, youall have to earn your reputation through your own activity and dealings.

6. For young doctors let me tell you one very important thing of yourprofessional life. Your real life has just started after your passing the finalexamination. This is time to earn and gather more pebbles of knowledge.Medical science is an ever-expanding universe, everyday it is discarding theold and some new are added. Yesterday's information has been made obsoleteby today and today's one might have the same faith by tomorrow. To addnewer information you should not have to wait for the text book and journal,please run through computer technology and internet. You all must becomputer literate

7. My young friends I have my faith on you. I am sure, you can give significantboost to the health situation in this country. Life is a really a race, I want tohand it over to you. You can definitely make better Bangladesh. Our failuresand shortcoming should not touch you and let your heart and soul be pure .with divine sprit.

Atthe end , let me quote a writing from the Epitaph of the great scholar & saintImam Gazali(R:)·

"Maan tazzub mccunum/cherer doctura/wali-e-khuda/meshawaat"

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Translation:

"I get wonderI get wonderTimes and againWhy should not a doctorBe the saint of Allah(Creator) "

Physician oath attached here with.